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Understanding the relationship between activation, utilization of healthcare services, distress, health literacy, and use of family and support resources in complex, high-risk patients: A structural equation modeling study

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Abstract

The primary purpose of this research is to examine the factors that predict health activation and overall utilization of healthcare services among high-risk, complex patients. Understanding these relationships is beneficial for patients’ health and continuity of care, for insurance providers to direct resources appropriately, and for healthcare clinicians to actively engage patients as partners.
Two empirical articles, each a focused examination of the multifaceted relationships between patients’ beliefs, behaviors, and health outcomes, are presented. Each article proposes and tests a hypothesized model, grounded in the literature and based on theoretical knowledge, which depicts multiple aspects of these relationships. Pre-existing, de-identified data (N=79) from a high-risk, complex patient population in an integrated family medicine practice are applied to the models using confirmatory factor analysis and structural equation modeling. The first article centers on the potential antecedents of health activation in complex patients; whereas the second article extends the focus by examining potential antecedents of healthcare service utilization. A final chapter provides a summary and examines the findings of both articles together.